HOUSING TIPS

QUESTIONS TO ASK SENIOR CARE FACILITY

NURSING HOMES

Credentials:

- Does it have a current operating license from the state?

- Does the administrator have an up-to-date state license?

- Does it have Medicare and Medicaid certification?

- Can it provide a list of references?

- How many years has it been in operation?

Cost:

- What would be the basic monthly or daily rate?

- What does the basic or monthly rate include and exclude?

- Will a breakdown of fees be provided in writing?

- Will the senior's family be informed in writing of fee increases?

- If the senior runs out of money, what assistance can the facility provide?

Staff:

- What is the staff-to-resident ratio?

- Are staff credentialed? What are the credentials?

- Does the facility require criminal background checks for employees?

- Are staff members trained in emergency procedures?

Services:

- Can the nursing home provide the level of assistance needed, given your medical condition?

- Are there medical conditions the nursing home will not accept? Which ones?

- Is there a doctor available on site for emergencies?

- Does the facility have an arrangement with a nearby hospital?

- Are there a variety of activities tailored to residents' needs and interests?

- Is there 24-hour access by phone?

- Are visiting hours restricted?

- Does the facility have a program limiting the use of restraints?

- Does it have an active resident and family council to watch out for senior rights?

Surroundings:

- Are there handrails in the hallways and grab bars in the bathrooms?

- Are there private ares for visits with family, friends or doctors?

- Are there areas for activities or social events?

- Is the nursing home clean and well-maintained?

- Is there an automatic fire alarm system and sprinklers?

- Are exits clearly marked and unobstructed?

- Is there an emergency response system or call buttons?

- Is there an adequate security system?

(To check on the quality of care provided by a certain nursing home, go to www.medicare.gov and click 'Nursing Home Compare.' For complaints and problems about nursing homes, adult residential care homes, and other licensed long term care facilities, call the state ombudsman at 586-0100.)

ASSISTED LIVING FACILITIES

Credentials:

- Is the facility licensed or certified by the state?

- Is it a member of any professional organizations? If so, which ones. You want to contact the organizations to check accreditation standards.

- Are staff members credentialed? What are the credentials?

- Can the facility provide a list of references?

Cost:

- Is there an entrance, application or deposit fee? If yes, how much?

- Will these fees be refunded, even partially, if the senior leaves the facility?

- What is the basic monthly or daily rate? Will a written breakdown of fees be provided?

- What do the rates include or exclude?

- Can the basic monthly rate be increased every month or annually?

- Is there a cap on how much the rate can be raised?

- Will there be additional charges for cable, phone service or newspaper delivery?

- Are the medical conditions that would require the senior to leave at some point?

- If the senior runs out of money, what assistance can the facility provide?

Staff:

- What is the staff-to-resident ratio?

- Is there a primary staff contact? A regular personal care worker?

- Is a nurse on duty 24 hours a day?

- Is the staff trained in emergency procedures? Did they go through criminal record checks?

Services:

- Is skilled nursing services provided, if needed?

- Does it provide help with eating, bathing, dressing, using the toilet, walking and other assistance, if needed?

- Does it provide services such as laundry, housekeeping and making sure seniors remember to take their medication?

- Can the family contract for services not provided by the facility?

- Does the facility provide social and recreational activities, as well as transportation for outside activities?

- Are there health promotion and exercise programs?

- Are there activities for seniors with dementia?

- If seniors need help with medications, can they choose their own pharmacy?

- Are special diets taken into consideration? Can meals be delivered to the room?

Surroundings:

- Can seniors choose which apartments to live in?

- Can units be adapted, or can a senior be moved to another unit, as needs change?

- Can seniors bring in their own furniture?

- Are there plenty of handrails and grab bars?

ADULT DAY CENTERS

Credentials:

- Is the center licensed or certified by the state?

- Is it accredited? If so, by which organization? Check out the accreditation standards.

- Are staff members credentialed? What are the credentials?

Cost:

- What is the hourly or daily rate? Can the family get a breakdown of all costs in writing?

- Are there extra fees you might charge?

- Is financial help available?

Staff:

- What is the staff-to-participant ratio?

- Do you train staff who will be caregivers?

- Do some staff members specialize in caring for seniors with dementia or memory loss?

- Is a nurse on duty when the center is open?

- Are staff members trained in emergency procedures and checked for criminal records?

Services:

- Does the staff create a care plan for each client to address unique needs?

- Do you monitor health signs such as blood pressure or weight? If so, which services?

- Are seniors given their medications or reminded to take them?

- Will a doctor be available?

- Are there designated areas for sick seniors?

- Are speech, physical and occupational therapy available?

- Are personal services such as bathing and shaving available? Will there be help for eating, walking and using the toilet, if needed?

- What social activities are provided?

- Will the facility cater to special dietary needs?

- Is there a pick-up and drop-off service?

- Are there support groups for family members?

Surroundings:

- Is the center safe and secure? Does it have an automatic fire alarm and sprinklers?

- Is it wheelchair accessible?

- Are there sufficient grab bars and handrails?

- Is there comfortable furniture?

- Is it clean and well-maintained?

For questions to ask other types of senior facilities, go to www.getcare.com and click on "search." To the right, under "Related Links," click on checklists.

SOURCE: RTZ Associates, a long-term care specialist based in Oakland, Calif.

AGENCIES AND CONTACT NUMBERS

HELP & REFERRAL

Elderly Affairs Division, City & County of Honolulu, Standard Finance Building, 715 S. King St., Suite 200. Case management, telephone hotline for information and referral to services, home visits, follow-up on frail elders, speakers, exhibits, newsletter, brochures and resource directories. 523-4545 or www.elderlyaffairs.com. Other county offices: Maui (808) 270-7774, Kaua'i (808) 241-4470 and the Big Island (808) 961-8600.

State Executive Office on Aging, 250 S. Hotel St., Suite 406. Acts as clearinghouse of information for the elderly and their families. 586-0100 or www2.hawaii.gov/eoa.

Eldercare Hawai'i, 2909 Lowrey Ave., Suite E. A planning and consultation service that offers support and classes for families with elders. Offers free booklet called "Residential Options for Hawai'i Seniors." 988-6300 or www.eldercarehawaii.com.

Kokua Mau, nonprofit organization devoted to helping people with end-of-life care. 585-9977, (800) 474-2113 from the Neighbor Islands or www.kokuamau.org.

National Council on Aging, Washington, D.C. A national network of organizations and individuals dedicated to improving the health and independence of older people; increasing their continuing contributions to communities, society and future generations; and building caring communities. (202) 479-1200, TDD (202) 479-6674 or www.ncoa.org.

AARP, Information Center, 1199 Dillingham Blvd., Unit A106. Provides general information on aging and sometimes acts as an advocate concerning fraud and abuse, age discrimination, prescription-drug issues and economic security. 843-1906 or www.aarp.org/hi.

MONEY ISSUES

Medicare, the nation's largest health insurance program that provides health insurance to those 65 or older regardless of income. (800) 633-4227 or www.medicare.gov.

State Department of Human Services, Information on Med QUEST and Medicaid. Med QUEST Information Line, 586-5390. Customer Service Branch, 524-3370, (800) 316-8005 from the Neighbor Islands or www.med-quest.us.

Medicaid, state-run health insurance program for low-income families with children, aged, blind or disabled people on Supplemental Security Income, certain low-income pregnant women and children, and certain people with very high medical bills. O'ahu 587-3521, Hilo (808) 933-0339, Kona (808) 327-4970, Lana'i (808) 565-7102, Maui (808) 243-5780, Moloka'i (808) 553-1758, Kaua'i (808) 241-3575. Also, Medicaid waiver programs can pay for care at your own home or at an adult residential care home such as Nursing Home Without Walls and Residential Alternative Community Care. O'ahu 832-5115, Hilo (808) 933-8820, Kona (808) 327-6280, Kaua'i (808) 241-3337, Maui (808) 243-5151.

Social Security Administration, Honolulu Office, Prince Kuhio Federal Building, Room 1-114. Apply for Medicare and obtain general information and service. (800) 772-1213 or www.ssa.gov.

SagePlus, state health insurance counseling program. Provides statewide health insurance information counseling and referrals to people 60 or older, their families and caregivers. Trained volunteer counselors provide free consultations and presentations. 586-7299 or (888) 875-9299 from the Neighbor Islands. Other county offices: Maui (808) 270-7774, Kaua'i (808) 241-6400 and the Big Island (808) 961-8777.

Centers For Medicare & Medicaid Services. CMS administers the Medicare program and works in partnership with the state to administer Medicaid. (877) 267-2323 or www.cms.hhs.gov.

National Reverse Mortgage Lenders Association offers a free guide to reverse mortgages, which are special loans that let homeowners 62 or older borrow against the equity of their home. (866) 264-4466 or www.reversemortgage.org.

LEGAL RESOURCES

Legal Aid Society of Hawaii, 924 Bethel St. Assistance with legal problems for those who qualify economically. 536-4302. Also at the Kahalu'u Key Project, 47-200 Waihe'e Road., No. 104, 239-6651; and 85-670 Farrington Highway, Wai'anae, 696-6321. Those older than 60 may receive free counseling through the senior hotline, 536-0011 or (888) 536-0011 from the Neighbor Islands.

Elder Law Program, University of Hawai'i-Manoa, William S. Richardson School of Law, 2515 Dole St. The program publishes a free workbook called "Deciding 'What If?' A Legal Handbook for Hawai'i's Caregivers, Families and Older Persons." 956-6544 or www.hawaii.edu/uhelp.

FUNERALS

National Funeral Directors Association. Provides advocacy, education, information, products, programs and services to help members enhance the quality of service to families. (800) 228-6332, (262) 789-1880 or www.nfda.org.

Funeral Consumers Alliance. A nonprofit organization dedicated to protecting a consumer's right to choose a meaningful, dignified, affordable funeral. www.funerals.org.

Funeral Consumers Alliance of Hawaii, formerly known as the Memorial Society of Hawaii. 638-5580.